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Test 3 Pharm and Physiology for Anesthesia
NSAIDS and Prostaglandins
13
Physiology
Graduate
11/03/2014

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Cards

Term
Eicosanoids are important for? 2x
Definition
1. inflammation
2. cellular signalling
Term
which COX is important for normal gastric mucosa and influences kidney funciton
Definition
cox 1
Term
Which COX enzyme do we want to target
Definition
Cox 2
Term
Explain the prostaglandin mechanism of action
Definition
prostaglandin act on gproteins that activates adenylcyclase which then increases intracellular cAMP. cAMP activates PKA. PKA causes decreasd free
Term
T/F do you need a normal balance of prostaglandins to maintain platelet activity and coagulation
Definition
TRUE
Term
What type of surgery would you be worried about for prostacylcin release? What are the Sx?
Definition
Bowel surgery like mesenteric traction. Causes large release of prostacyclins which can vasodilate, and inhibit platelet aggregation. Results in flushing of face, hypotension, increased HR and sweating.
Term
What are the four effects of nonsteroidals
Definition
1. analgesia
2. anti-inflammatory
3. antipyretic
4. platelet inhibition
Term
What is the mechanism of action of nsaids
Definition
inhibits cyclooxygenase activity which results in the decrease in peripheral synthesis of prostaglandins. By decreasing porstaglandin synthesis we decrease the inflammation associated with it. It also helps with pain and decreases nociception.
Term
toradol (ketorolac) is contraindicated in what kind of patients
Definition
pts with peptic ulcer disease
Term
what is ASA triad
Definition
Aspirin can induce asthma in 8-20% of people. Its related to the release of leukotrienes. People at greatest risk have these three risk factors:
1. rhinosinusitis
2. nasal polyps
3. asthma

Its life threatening and often occurs 1-3 hours after taking it.
Term
Histamine is primarily found where?
Definition
1. Mast Cells
2. Basophils
3. Enterochromaffin like cells (ECLs)
4. some neurons
Term
What are the key signs most noticable during anesthesia for anaphylaxis or anaphylactoid?
Definition
1. hives
2. bronchoconstriction (peak airway pressures)
3. hypotension
Term
Treatment for anaphylaxis
Definition
1. 100% FiO2
2. Epi IV or IM at 0.01-0.5
3. Intubate if necessary
4. IV fluids 1-2 liters LR wide open
5. Benadryl 50-75 mg IV
6. Pepcid: 20mg IV
7. Vassopressor (EPI) gtt if needed.
8. Steroids
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